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SEATTLE (AP) — Donald Douglass had a small spot on his forehead when he went to the Seattle Veterans Affairs hospital in 2011.

A biopsy confirmed it was cancerous. But it was four months before the hospital scheduled an appointment for him to have it removed — and by then, it had spread, wrapping around a facial nerve and eventually getting into his blood.

The delay proved fatal, his lawyer said — and it mirrors concerns being raised about the VA system nationally.

“There was no reason for this procedure to be delayed,” said the attorney, Jessica Holman of Tacoma. “Had he had his surgery timely, he’d be alive today.”

Congress has been in an uproar over allegations of treatment delays and preventable deaths at VA hospitals, with more than two dozen facilities being investigated nationwide. At the VA hospital in Phoenix, 40 veterans allegedly died while waiting for treatment, and staff there reportedly kept a secret list of patients waiting for appointments to hide delays in care.

It isn’t known whether the VA Puget Sound Health Care System is among those being investigated; the VA’s inspector general has not named the organizations being probed. While Democratic Sen. Patty Murray has raised questions about understaffing and budget shortfalls at the VA hospital in Spokane, no evidence of systemic problems at the Seattle VA hospital has surfaced publicly. Chad Hutson, a spokesman for VA Puget Sound, declined to comment Tuesday.

But Holman said she’s hard-pressed to believe Douglass’ case was unrelated to the broader problems.

His sister, Constance Olberg of Sammamish, was his caregiver toward the end of his life and brought the medical negligence claim on behalf of his estate. In an answer to the complaint filed in U.S. District Court, the VA denied any liability.

Douglass, an Army veteran who went by “Cliff,” previously suffered liver cancer and had a liver transplant in 2009, Holman said. He was doing well with the new organ, and he continued taking drugs that suppressed his immune system so his body would not reject it.

That made it all the more urgent that the spot on his forehead be removed immediately, Holman said, arguing that his weakened immune system could allow the cancer to spread more quickly.

Transplant patients with suppressed immune systems face a much higher risk of skin cancer, according to The Skin Cancer Foundation, a nonprofit organization dedicated to fighting the disease.

While the VA said it would schedule an appointment for Douglass to have the surgery at the University of Washington Medical Center, it dragged its feet, Holman said. Douglass repeatedly checked in about whether the appointment had been scheduled, and there are notes in his patient file indicating that he was still waiting for the surgery, she said.

The surgery was finally performed in September 2011, but the cancer had spread. Douglass suffered facial pain and paralysis, and he died a little more than a year later.

“He was very angry,” Holman said. “He was angry that a paperwork snafu had caused this.”

Douglas, 57, was stationed in Germany in the mid-1970s. He recently had operated a Christmas tree farm in North Bend, Holman said.

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